Serum Iron Levels and Copper-to-Zinc Ratio in Sickle Cell Disease

Sickle cell disease (SCD) is an inherited disorder and a major health challenge in Nigeria. Micronutrient deficiencies often associated with the disorder may cause inflammation and abnormal metabolism in the body. The copper-to-zinc ratio is a more relevant diagnostic measure than the concentration of either metal alone in clinical practice. This study seeks to evaluate serum levels of c-reactive protein (CRP), copper, zinc and the copper-to-zinc ratio, and to correlate the latter with CRP in adult subjects with SCD. Serum copper, zinc, CRP and plasma fibrinogen were assayed in 100 confirmed SCD patients in steady clinical state and 100 age- and sex-matched subjects with normal hemoglobin. Serum copper and zinc were assayed by the colorimetric method using reagents supplied by Centronic, Germany, while CRP and fibrinogen were assayed using reagents supplied by Sigma (St. Louis, MO, USA) and Anogen (Ontario, Canada), respectively. The copper-to-zinc ratio was calculated from serum levels of copper and zinc. The measured parameters were compared between the groups using the Students t-test, and the Pearson correlation coefficient was used to relate CRP with the other parameters. Serum copper, CRP, fibrinogen and the copper-to-zinc ratio were significantly higher (p < 0.001), while zinc level was lower in SCD patients than in controls. Serum CRP concentration correlated with copper (r = 0.10; p < 0.02), zinc (r = −0.199; p < 0.05) and the copper-to-zinc ratio (r = 0.312; p < 0.002), but the correlation between CRP and fibrinogen was not significant. Inflammation may modulate copper and zinc homeostasis, and the copper-to-zinc ratio may be used as a marker of nutritional deficiency and inflammation in SCD patients.

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Copper-to-Zinc Ratio Correlates with an Inflammatory Marker in Patients with Sickle Cell Disease (Version 1)

Sci ◽

10.3390/sci1020034 ◽

2019 ◽

Vol 1 (2) ◽

pp. 34

Author(s):

Mathias Abiodun Emokpae ◽

Emmanuel Babatunde Fatimehin

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Serum Levels ◽

Serum Copper ◽

The Body ◽

Zinc Homeostasis ◽

Clinical State ◽

Cell Disease ◽

Copper And Zinc ◽

Copper Zinc

Sickle cell disease (SCD) is an inherited disorder of major health challenge in Nigeria. Micronutrients deficiencies often associated with the disorder may cause inflammation and abnormal metabolisms in the body. The copper-to-zinc ratio is a more important assessment than the concentrations of either of the metals in clinical practice. This study seeks to evaluate serum levels of c-reactive protein (CRP), copper, zinc and copper-to-zinc ratio and to correlate copper-to-zinc ratio with CRP in adult subjects with SCD. Serum copper, zinc, CRP and plasma fibrinogen were assayed in 100 confirmed SCD patients in steady clinical state and 100 age and sex matched subjects with normal haemoglobin. Serum copper and zinc were assayed by colorimetric method using reagents supplied by Centronic, Germany while CRP and fibrinogen were assayed using reagents supplied by Sigma (St. Louis, MO, USA) and Anogen (Ontario, Canada), respectively. The copper to zinc ratio was calculated from serum levels of copper and zinc. The measured parameters were compared between the groups using Students t-test and Pearson correlation coefficient was used to relate CRP with the other parameters. Serum copper, CRP, fibrinogen and copper-to-zinc ratio were significantly higher (p < 0.001) while zinc level was lower in SCD patients than controls. Serum CRP concentration correlated with copper (r = 0.10; p < 0.02), zinc (r = −0.199; p < 0.05) and Copper-to-zinc ratio (r = 0.312; p < 0.002) but the correlation between CRP and fibrinogen was not significant. Inflammatory condition may modulate copper and zinc homeostasis and copper-to-zinc ratio may be used as marker of nutritional deficiency and inflammation in SCD patients.

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Copper-to-Zinc Ratio Correlates with an Inflammatory Marker in Patients with Sickle Cell Disease

Sci ◽

10.3390/sci1020055 ◽

2019 ◽

Vol 1 (2) ◽

pp. 55

Author(s):

Mathias Abiodun Emokpae ◽

Emmanuel Bamidele Fatimehin

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Serum Levels ◽

Serum Copper ◽

The Body ◽

Zinc Homeostasis ◽

Clinical State ◽

Cell Disease ◽

Copper And Zinc ◽

Copper Zinc

Sickle cell disease (SCD) is an inherited disorder of major health challenge in Nigeria. Micronutrients deficiencies often associated with the disorder may cause inflammation and abnormal metabolisms in the body. The copper-to-zinc ratio is a more important assessment than the concentrations of either of the metals in clinical practice. This study seeks to evaluate serum levels of c-reactive protein (CRP), copper, zinc and copper-to-zinc ratio and to correlate copper-to-zinc ratio with CRP in adult subjects with SCD. Serum copper, zinc, CRP and plasma fibrinogen were assayed in 100 confirmed SCD patients in steady clinical state and 100 age and sex matched subjects with normal haemoglobin. Serum copper and zinc were assayed by colorimetric method using reagents supplied by Centronic, Germany while CRP and fibrinogen were assayed using reagents supplied by Sigma (St. Louis, MO, USA) and Anogen (Ontario, Canada), respectively. The copper to zinc ratio was calculated from serum levels of copper and zinc. The measured parameters were compared between the groups using Students t-test and Pearson correlation coefficient was used to relate CRP with the other parameters. Serum copper, CRP, fibrinogen and copper-to-zinc ratio were significantly higher (p < 0.001) while zinc level was lower in SCD patients than controls. Serum CRP concentration correlated with copper (r = 0.10; p < 0.02), zinc (r = −0.199; p < 0.05) and Copper-to-zinc ratio (r = 0.312; p < 0.002) but the correlation between CRP and fibrinogen was not significant. Inflammatory condition may modulate copper and zinc homeostasis and copper-to-zinc ratio may be used as marker of nutritional deficiency and inflammation in SCD patients.

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Serum Potassium, Sodium, and Chloride Levels in Sickle Cell Disease Patients and Healthy Controls: A Case-Control Study at Korle-Bu Teaching Hospital, Accra

Biomarker Insights ◽

10.1177/1177271919873889 ◽

2019 ◽

Vol 14 ◽

pp. 117727191987388

Author(s):

Charles Antwi-Boasiako ◽

Yaw A Kusi-Mensah ◽

Charles Hayfron-Benjamin ◽

Robert Aryee ◽

Gifty Boatemaah Dankwah ◽

...

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Serum Sodium ◽

Serum Potassium ◽

Serum Levels ◽

Case Control ◽

Healthy Controls ◽

Cell Disease ◽

Serum Electrolyte ◽

Flame Atomic Absorption

The activity of Na+-K+ ATPase is altered in sickle cell disease (SCD), which affects serum electrolyte levels. This alteration is associated with several complications in sickle cell patients. This study evaluated the serum levels of sodium, potassium, and chloride in patients with SCD. The study was a case-control cross-sectional study involving 120 SCD patients in the steady state and 48 ‘healthy’ controls. The SCD patients were made up of 69 HbSS patients and 41 HbSC patients. Serum electrolyte levels (Na+, K+, and Cl−) were measured using a Flame Atomic Absorption Spectrometer (Variant 240FS; Varian Australia Pty Ltd). Serum sodium levels were significantly lower in the sickle cell patients, compared with their ‘healthy’ counterparts ( P = .0001). Although the study found significantly higher serum levels of potassium in the SCD patients ( P = .0001), there was no significant difference in serum chloride levels between patients with SCD and the controls ( P = .098). Serum sodium and chloride levels were not significantly different in both HbSS and HbSC patients ( P = .197 and P = .553, respectively). The level of serum potassium in the HbSS patients was, however, significantly higher compared with those with the HbSC genotype ( P = .0001). There is higher efflux of K+ from the intracellular into the extracellular space in HbSS patients, which may lead to red cell membrane dysfunction and associated complications.

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Total Serum Magnesium Levels and Calcium-To-Magnesium Ratio in Sickle Cell Disease

Medicina ◽

10.3390/medicina55090547 ◽

2019 ◽

Vol 55 (9) ◽

pp. 547

Author(s):

Antwi-Boasiako ◽

Kusi-Mensah ◽

Hayfron-Benjamin ◽

Aryee ◽

Dankwah ◽

...

Keyword(s):

Sickle Cell Disease ◽

Sickle Cell ◽

Serum Magnesium ◽

Total Serum ◽

Healthy Controls ◽

Cell Disease ◽

Flame Atomic Absorption ◽

Significant Difference ◽

Calcium Magnesium ◽

Cell Dehydration

Background and objectives: Imbalance of calcium/magnesium ratio could lead to clinical complications in sickle cell disease (SCD). Low levels of magnesium have been associated with sickling, increased polymerization and vaso-occlusion (VOC) in sickle cell due to cell dehydration. The K-Cl cotransport plays a very important role in sickle cell dehydration and is inhibited by significantly increasing levels of magnesium. The study evaluated total serum magnesium levels and computed calcium/magnesium ratio in SCD patients and “healthy” controls. Materials and methods: The study was a case-control cross-sectional one, involving 120 SCD patients (79 Haemoglobin SS (HbSS)and 41 Haemoglobin SC (HbSC)) at the steady state and 48 “healthy” controls. Sera were prepared from whole blood samples (n = 168) and total magnesium and calcium measured using a Flame Atomic Absorption Spectrometer (Variant 240FS manufactured by VARIAN Australia Pty Ltd., Melbourne, VIC, Australia). Calcium/magnesium ratios were calculated in patients and the controls. Results: The prevalence of hypomagnesemia and hypocalcaemia among the SCD patients was observed to be 39.17% and 52.50% respectively, higher than the controls (4.17% and 22.92%, for hypomagnesemia and hypocalcaemia, respectively). Level of magnesium was significantly lower in the SCD patients compared to their healthy counterparts (p = 0.002). The magnesium level was further reduced in the HbSS patients but not significantly different from the HbSC patients (p = 0.584). calcium/magnesium ratio was significantly higher in the SCD patients (p = 0.031). Although calcium/magnesium ratio was higher in the HbSC patients compared to those with the HbSS genotype, the difference was not significant (p = 0.101). Conclusion: The study shows that magnesium homeostasis are altered in SCD patients, and their levels are lower in HbSS patients. Although calcium/magnesium ratio is significantly higher in SCD patients compared with controls, there is no significant difference between patients with HbSS and HbSC genotypes. Magnesium supplementation may be required in sickle cell patients.

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Sickle Cell Disease: Role of Oxidative Stress and Antioxidant Therapy

Antioxidants ◽

10.3390/antiox10020296 ◽

2021 ◽

Vol 10 (2) ◽

pp. 296

Author(s):

Rosa Vona ◽

Nadia Maria Sposi ◽

Lorenza Mattia ◽

Lucrezia Gambardella ◽

Elisabetta Straface ◽

...

Keyword(s):

Oxidative Stress ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Globin Gene ◽

Organ Damage ◽

Cell Disease ◽

Vessel Occlusion ◽

Antioxidant Agents ◽

Oxidant Status

Sickle cell disease (SCD) is the most common hereditary disorder of hemoglobin (Hb), which affects approximately a million people worldwide. It is characterized by a single nucleotide substitution in the β-globin gene, leading to the production of abnormal sickle hemoglobin (HbS) with multi-system consequences. HbS polymerization is the primary event in SCD. Repeated polymerization and depolymerization of Hb causes oxidative stress that plays a key role in the pathophysiology of hemolysis, vessel occlusion and the following organ damage in sickle cell patients. For this reason, reactive oxidizing species and the (end)-products of their oxidative reactions have been proposed as markers of both tissue pro-oxidant status and disease severity. Although more studies are needed to clarify their role, antioxidant agents have been shown to be effective in reducing pathological consequences of the disease by preventing oxidative damage in SCD, i.e., by decreasing the oxidant formation or repairing the induced damage. An improved understanding of oxidative stress will lead to targeted antioxidant therapies that should prevent or delay the development of organ complications in this patient population.

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Oxidative stress in sickle cell disease; pathophysiology and potential implications for disease management

American Journal of Hematology ◽

10.1002/ajh.22012 ◽

2011 ◽

Vol 86 (6) ◽

pp. 484-489 ◽

Cited By ~ 114

Author(s):

Erfan Nur ◽

Bart J. Biemond ◽

Hans-Martin Otten ◽

Dees P. Brandjes ◽

John-John B. Schnog ◽

...

Keyword(s):

Oxidative Stress ◽

Sickle Cell Disease ◽

Disease Management ◽

Sickle Cell ◽

Cell Disease

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Oxidative stress, malaria, sickle cell disease, and innate immunity

Trends in Immunology ◽

10.1016/j.it.2021.08.008 ◽

2021 ◽

Author(s):

Huan Cao ◽

Mark A. Vickers

Keyword(s):

Oxidative Stress ◽

Innate Immunity ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Cell Disease

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Influence of Haptoglobin Polymorphism on Stroke in Sickle Cell Disease Patients

Genes ◽

10.3390/genes13010144 ◽

2022 ◽

Vol 13 (1) ◽

pp. 144

Author(s):

Olivia Edwards ◽

Alicia Burris ◽

Josh Lua ◽

Diana J. Wilkie ◽

Miriam O. Ezenwa ◽

...

Keyword(s):

Oxidative Stress ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Blood Cells ◽

Cell Disease ◽

Free Hemoglobin ◽

Cerebral Tissue ◽

Sickle Hemoglobin ◽

Haptoglobin Polymorphism

This review outlines the current clinical research investigating how the haptoglobin (Hp) genetic polymorphism and stroke occurrence are implicated in sickle cell disease (SCD) pathophysiology. Hp is a blood serum glycoprotein responsible for binding and removing toxic free hemoglobin from the vasculature. The role of Hp in patients with SCD is critical in combating blood toxicity, inflammation, oxidative stress, and even stroke. Ischemic stroke occurs when a blocked vessel decreases oxygen delivery in the blood to cerebral tissue and is commonly associated with SCD. Due to the malformed red blood cells of sickle hemoglobin S, blockage of blood flow is much more prevalent in patients with SCD. This review is the first to evaluate the role of the Hp polymorphism in the incidence of stroke in patients with SCD. Overall, the data compiled in this review suggest that further studies should be conducted to reveal and evaluate potential clinical advancements for gene therapy and Hp infusions.

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